A recent strike settlement between the Los Angeles Unified School District and its teachers union called for hiring 340 school nurses by the 2020-21 school year, and teachers striking in Oakland, California, also want more nurses. But the state already has a nursing shortage, and in Los Angeles, for example, filling these roles in schools is especially hard when the district pays an average of less than $80,000 and an average registered nurse in the metro area makes $95,000, EdSource reports.
EdSource cites a statistic from KidsData.org, which says as of 2017, California's student-to-nurse ratio was roughly 2,500-to-1. The shortage is compounded by insufficient numbers of nursing school instructors and a long, pricey credentialing process that, on top of getting a nursing degree, can add up to two additional years and cost more than $10,000.
- Possible solutions, EdSource notes, include aggressive recruitment efforts that showcase benefits such as better schedules and time off, increasing salary schedules, and offering increased support and resources. San Jose Unified School District, for example, has had success with offering mentoring programs for new school nurses.
While EdSource notes the nursing shortage's prominence in California, it's also affecting almost every other state in the U.S. Unlike some teacher shortages, this issue doesn't largely stem from a lack of people who want to pursue the profession, but a lack of people to teach would-be nurses and a lack of nurses willing to take their profession to a school building.
The growing demand for school nurses, combined with a shrinking candidate pool, has created a competitive proposition, and many districts simply cannot compete with the salary demands and often do not have sufficient funding. Add to that the number of nurses who were cut from school districts during the recession, and many are operating well above the 750-to-1 student-to-nurse ratio established by the National Association of School Nurses.
The role of a school nurse is important, and leaders need to tout the benefits of these roles as they recruit. School nurses work get to work with children, and the physical job demands can be less stressful than working with an adult population at any hour of the day. They also generally have more autonomy and work about 185 days a year, and though they may be paid less than other nurses, the fixed schedule can allow for time to take on spot assignments through health care agencies. This additional income can help make up for any difference in salary, and it's arguably a worthwhile profession that impacts the lives of students daily.
However, like anything, the role has its downsides. Some states, including California, require certifications on top of a degree, and nurses that do work in schools are often overstretched and covering too many students at too many schools—a situation that is stressful and requires traveling between sites. These positions are also vulnerable to budget cuts during times of economic upheaval.
Until a better solution arises, many school leaders are exploring creative solutions to meeting health care needs. Some states fund school nurses through local health departments, so partnering with them could be a potential solution. Establishing community school models, where health clinics can operate onsite, can also expand access to medical services while cutting the amount of time student spend out of class for medical appointments. Other schools are using a combination of telemedicine, health room technicians or school staff members trained in emergency procedures to meet the need. In the end, a combination of better recruitment techniques and innovative solutions will likely help districts recover nursing staff.